Clinical Predictors of Postpartum Persistent Hypothyroidism in Gestational Hypothyroidism: A Cohort Study
- 1Department of Internal Medicine, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey
- 2Department of Internal Medicine, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
Abstract
Objective: The aims of this study were to determine whether gestational timing, biochemical severity, treatment response, or metabolic parameters predict postpartum persistent hypothyroidism and to evaluate the contribution of thyroid autoimmunity.
Material and Methods: This single-center retrospective cohort study included pregnant women newly diagnosed with hypothyroidism in an internal medicine outpatient clinic. Recorded variables included demographic characteristics, gestational age at diagnosis, baseline thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels, follow-up thyroid function tests, fasting glucose, oral glucose tolerance test results, gestational diabetes diagnosis, and thyroid function at 6 weeks postpartum. Patients were categorized into early (≤13 weeks), mid (14–27 weeks), and late (≥28 weeks) diagnosis groups. Associations between gestational timing, treatment response, glycemic parameters, and postpartum persistent hypothyroidism were analyzed.
Results: Fifty-eight women were included. Trimester-specific TSH targets were achieved in 32/58 (55.2%) at the first follow-up and 42/58 (72.4%) at the second follow-up. Early diagnosis, baseline TSH, levothyroxine dose, gestational timing, and glycemic indices were not associated with TSH normalization or postpartum persistent hypothyroidism (all p > 0.05). Postpartum persistent hypothyroidism developed in 14/58 women (24.1%). Thyroid autoantibody positivity was associated with persistence (p = 0.006) and remained independently associated with postpartum persistent hypothyroidism in multivariable analysis (odds ratio 9.78, 95% confidence interval 2.10–44.30; p = 0.020). TSH target achievement was not associated with reduced hyperglycemia.
Conclusions: Thyroid autoimmunity emerged as the principal determinant of postpartum persistent hypothyroidism, supporting antibody-based risk stratification. Gestational timing, treatment response, and metabolic indices were not significantly associated with postpartum thyroid outcomes.
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BibTeX
@article{aydın2026clinical,
title = {{Clinical Predictors of Postpartum Persistent Hypothyroidism in Gestational Hypothyroidism: A Cohort Study}},
author = {Büşra Çetintulum Aydın and Seher İrem Şahin and Ece Çiftçi Öztürk and Hüseyin Öztürk and Hayriye Esra Ataoğlu},
journal = {Medical Principles and Practice},
year = {2026},
month = sep,
doi = {10.1159/mpp/adpag024},
url = {https://doi.org/10.1159/mpp/adpag024},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Clinical Predictors of Postpartum Persistent Hypothyroidism in Gestational Hypothyroidism: A Cohort Study
AU - Büşra Çetintulum Aydın
AU - Seher İrem Şahin
AU - Ece Çiftçi Öztürk
AU - Hüseyin Öztürk
AU - Hayriye Esra Ataoğlu
PY - 2026
DA - 2026/09/15
JO - Medical Principles and Practice
DO - 10.1159/mpp/adpag024
UR - https://doi.org/10.1159/mpp/adpag024
AB - Objective: The aims of this study were to determine whether gestational timing, biochemical severity, treatment response, or metabolic parameters predict postpartum persistent hypothyroidism and to evaluate the contribution of thyroid autoimmunity. Material and Methods: This single-center retrospective cohort study included pregnant women newly diagnosed with hypothyroidism in an internal medicine outpatient clinic. Recorded variables included demographic characteristics, gestational age at diagnosis, baseline thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels, follow-up thyroid function tests, fasting glucose, oral glucose tolerance test results, gestational diabetes diagnosis, and thyroid function at 6 weeks postpartum. Patients were categorized into early (≤13 weeks), mid (14–27 weeks), and late (≥28 weeks) diagnosis groups. Associations between gestational timing, treatment response, glycemic parameters, and postpartum persistent hypothyroidism were analyzed. Results: Fifty-eight women were included. Trimester-specific TSH targets were achieved in 32/58 (55.2%) at the first follow-up and 42/58 (72.4%) at the second follow-up. Early diagnosis, baseline TSH, levothyroxine dose, gestational timing, and glycemic indices were not associated with TSH normalization or postpartum persistent hypothyroidism (all p > 0.05). Postpartum persistent hypothyroidism developed in 14/58 women (24.1%). Thyroid autoantibody positivity was associated with persistence (p = 0.006) and remained independently associated with postpartum persistent hypothyroidism in multivariable analysis (odds ratio 9.78, 95% confidence interval 2.10–44.30; p = 0.020). TSH target achievement was not associated with reduced hyperglycemia. Conclusions: Thyroid autoimmunity emerged as the principal determinant of postpartum persistent hypothyroidism, supporting antibody-based risk stratification. Gestational timing, treatment response, and metabolic indices were not significantly associated with postpartum thyroid outcomes.
SN - 1011-7571
SN - 1423-0151
ER -